Erythrodermic Psoriasis

Treatment of Erythrodermic Psoriasis

This is a more serious form of psoriasis which requires expert medical treatment. A patient suffering from erythrodermic psoriasis generally needs to be hospitalized. The temperature and humidity in the room should be controlled according to the patient's comfort levels. 'Erytho' has a definition of 'red' while erythrodermic means 'red skin'. So one of the best ways to start treatment is making sure that your body is well hydrated with 8 to 14 glasses of water daily depending on body size and dryness of your area.

The topical therapy prescribed for erythrodermic psoriasis includes an oil-based bath followed by application of moisturizers such as jojoba oil. Jojoba oil is a wax ester which is the most similar to the oil naturally produced by the skin. For this reason it is the least likely to cause a reaction. Jojoba oil, moisturizers or emollients including bath oils can be applied to the affected areas of psoriasis skin as frequently as needed to relieve symptoms of itching, scaling and dryness. Moisturizers should also be used on the unaffected skin to reduce dryness. Moisturizing therapy helps to restore one of the skin's most important functions, which is to form a barrier to prevent the spread of bacteria and viruses from getting into the body and therefore help to prevent a rash becoming infected.

Topical steroids are never used. Antibiotics may be prescribed for the treatment of secondary infection, and oral steroids may be used to help control and stem the progression of the condition.

The medical staff may also recommend the use of immune suppressing therapy with medications such as methotrexate, cyclosporine, azothioprine or a similar drug. Oral retinoids are effective in some patients.

Additional treatment to address any issues that may arise such as of the cardiac, renal, fluid, electrolyte, and protein replacement therapy may also be required.

What is Erythrodermic Psoriasis?

Erythrodermic psoriasis is a complication of an existing condition which may occur in 1-2% of cases of psoriasis. It generally appears in people who have unstable type of plaque psoriasis, where the disease is progressively worsening.

Symptoms of Erythrodermic Psoriasis

The symptoms of Erythrodermic Psoriasis include a red rash, over large skin areas and characterized by intense redness and swelling, exfoliation of dead skin, and pain. Individuals with this type of psoriasis may experience chills, low-grade fever, and a general feeling of discomfort. Erythrodermic psoriasis appears on the skin as a widespread reddening and exfoliation of fine scales, often accompanied by severe itching and pain.

The patient's skin is very red with malfunctioning skin that does not retain water. So usually the patient needs much more water than the normal person to stay properly hydrated and to aid in new skin cell regeneration and healing. The additional water will also aid in maintaining the inner core temperature as the patient usually feels to feel cold or more likely to have hypothermia.

Benign enlargement of lymph nodes known as lipomelanotic reticulosis is common in erythrodermic psoriasis. This is caused by the absorption of impurities and an inflammatory response to the peeling of the skin.

The Cause of Erythrodermic Psoriasis

Erythrodermic psoriasis may occur as a result of complications in the treatment of atopic dermatitis, drug reactions from medications used to treat another condition, lymphoma, contact allergic dermatitis, or pityriasis rubra pilaris. It may occur in association with von Zumbusch pustular psoriasis. Zumbusch psoriasis affects elderly sufferers more seriously than the younger ones, and has the potential to be life-threatening for older people. Although occurring less frequently in children, it will improve more rapidly in them and might be treated without medication. In 50% of erythrodermic psoriasis cases, there is no known cause. When no cause can be found it may be referred to as an idiopathic exfoliative erythroderma.

Erythrodermic psoriasis is usually caused by the sudden withdrawal of systemic corticosteroids or potent topical steroids, psoriasis therapy involving the use of medications such as chloroquin or beta adrenergic receptor blockers, or due to treatment with excessive amounts of tar or dithranol.


Ear Psoriasis

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Psoriasis is commonly found in the ears too. Ear Psoriasis can appear as dry scales in the ear canal. Psoriasis in the ears can cause scale buildup that blocks the ear canal.

This scaling, when combined with normal earwax, can sometimes produce the physical blockage of the external ear canal leading to a temporary decrease in hearing. Psoriasis generally occurs in the external ear canal, not inside the ear or behind the eardrum. It also occurs behind the ear so this area has to be checked to look for the plaques if the diagnosis of psoriasis is considered. Dryness of the skin in the ear, with some scaling is characteristic of psoriasis. Ear psoriasis generally occurs in the external ear canal, not inside the ear or behind the eardrum.

Psoriasis of the ears occurs in approximately 18 percent of all patients at some time.

The eardrum is easily damaged. It is best to avoid picking and scratching the affected areas of the ear. Careful cleansing of the ear area can be done using over-the-counter ear-cleaning kits that involve squirting small amounts of fluid into the ear and letting it drain. Plain warm water, followed by a thin layer of mineral oil applied with a cotton swab, is also effective for some people. Wearing wax ear plugs at night helps to keep the affected ear canal from drying out and thereby reduces the severity of ear psoriasis.